Does intussusception require a CT scan?

Written by Hu Qi Feng

Pediatrics

Updated on September 11, 2024

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Intussusception is commonly diagnosed through routine abdominal ultrasound examinations, which have a positive rate of over 90%. In the ultrasound, the transverse section of the intussusception can show concentric circles or target ring-shaped mass images, and the longitudinal section may reveal the sleeve sign. Additionally, a barium enema can be employed, along with X-ray imaging. Under X-ray, the lead point of intussusception appears as a mass shadow, and air enema reduction treatment can be performed concurrently. Generally, CT is not used as a routine diagnostic tool.

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Written by Hu Qi Feng

Pediatrics

42sec

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Can intussusception heal itself?

Once intestinal intussusception occurs, only a small part can be spontaneously reduced. In most cases, urgent reduction treatment is required, including non-surgical and surgical treatments. Non-surgical treatment mainly involves enema therapy. Within 48 hours of the intussusception, if the overall condition is good, the abdomen is not distended, and there are no obvious signs of dehydration or electrolyte imbalance, barium enema treatment can be applied. If the duration of the intussusception exceeds 48 to 72 hours, or if the condition is severe with intestinal necrosis or perforation, surgical treatment is necessary.

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Written by Quan Xiang Mei

Pediatrics

50sec

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How to treat intussusception in children?

Intussusception in children is a common surgical condition. The treatment approach depends on the severity of the child's clinical symptoms. If the intestines have not been telescoped for long, and the intestinal mucosa has not suffered ischemic necrosis, and if the clinical symptoms are mild, air enema can be used to relieve the intussusception without the need for surgery. However, if the clinical symptoms are severe and necrosis has been prolonged, meaning the intestinal mucosa has reached a state of ischemia and necrosis that is irreparable, surgical treatment in a surgical setting is definitely required. Whether surgery or air enema is needed should be decided based on the actual color ultrasound results and a comprehensive diagnosis by the clinician.

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Written by Zhang Peng

General Surgery

55sec

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Causes of Intussusception in the Elderly

Intussusception refers to an obstruction caused by one segment of the intestine entering an adjacent segment, which can occur at any age. In adults, over 85% of intussusception cases can be attributed to organic lesions, typically tumors, but also possibly due to polyps or diverticula in the intestines. Typical symptoms of intussusception may include abdominal pain, an abdominal mass, and jelly-like bloody stool. In adults, intussusception is generally treated surgically. The surgical approach often involves exploratory laparotomy, possibly involving intestinal resection and anastomosis. For the resected part, reinforced suturing is usually required. If a primary anastomosis cannot be tolerated, procedures such as creating a stoma or exteriorizing the intestine may be performed, awaiting stabilization of the condition before further treatment.

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Written by Hu Qi Feng

Pediatrics

1min 30sec

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Infant Intussusception Symptoms and Treatment

Clinical manifestations of intussusception include: firstly, abdominal pain, which is paroxysmal, regular, and characterized by sudden episodes of colicky pain. The child may cry, appear restless, draw knees to the abdomen, have a pale face, and experience pain that lasts for several minutes or longer. The pain subsides, and the child may fall asleep quietly, but the pain typically recurs at intervals of ten to twenty minutes. Secondly, vomiting is an early symptom, initially reflexive and containing curds and food residue, later possibly including bile. Thirdly, bloody stools are an important symptom, with about 85% of cases passing jelly-like mucoid bloody stools within six to twelve hours after onset. Fourthly, an abdominal mass is often located in the upper right abdomen below the costal margin, where a slightly prominent intussusception mass can be felt. In terms of systemic symptoms, the general condition is good in the early stages, with no symptoms of systemic poisoning. As the disease progresses, the condition worsens, and complications such as intestinal necrosis or peritonitis may develop, leading to deterioration of systemic symptoms and possibly resulting in dehydration, high fever, coma, shock, and other toxic symptoms. Treatment methods include both surgical and non-surgical treatments.

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Written by Hu Qi Feng

Pediatrics

51sec

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Why does intussusception cause bloody stool?

Once intussusception occurs, only a small portion of the small intestine intussusceptions can reset themselves. Due to the continuous spasm of the sheathed intestinal tract, microcirculatory disorders occur in the intussuscepted segment. Initially, venous blood flow is obstructed, leading to tissue congestion and edema, venous varicosity, and mucosal cells secrete a large amount of mucus into the intestinal lumen, which mixes with blood and feces to form a jam-like jelly substance that is expelled. The intestinal wall becomes edematous, and the obstruction of venous return worsens, affecting the arteries, resulting in insufficient blood supply, and leading to systemic toxic symptoms. In severe cases, intestinal perforation and peritonitis can occur.